Understanding Periodontal Disease

Periodontal disease, commonly known as gum disease, has various stages, with gingivitis as its initial phase, resulting from plaque buildup, causing gum inflammation and bleeding. If not addressed promptly, it advances to periodontitis, a more severe stage that affects the bone and supportive tissues around the teeth.

To prevent its progression, it's crucial to promptly address gingivitis. Unfortunately, misconceptions about gum disease can hinder early intervention. Therefore, increasing awareness of its prevalence and debunking oral health myths are essential steps in promoting timely detection and effective management of periodontal disease.

What are the causes for Gum Disease?

The primary cause of gingivitis is the accumulation of plaque on the teeth. Gingivitis is often referred to as the initial stage of gum disease. If left untreated, gingivitis can advance to periodontitis or advanced gum disease. Let us reflect on some of the reasons that might contribute to Gum Disease.

Neglecting oral hygiene: Poor oral hygiene, like infrequent brushing and flossing, is a major cause of gum disease due to plaque buildup. Prioritize good oral hygiene.

Smoking and tobacco use: Smoking and tobacco use harm oral and overall health, significantly raising gum disease risk. Quitting is crucial.

Genetics: Some individuals are genetically predisposed to gum disease, making it imperative for them to pay close attention to oral health and receive regular dental checkups.

Certain medications: While not directly causing gum disease, certain antibiotics and medications can have side effects that increase the likelihood of developing periodontal disease.

Certain chronic illnesses: Chronic conditions like diabetes and rheumatoid arthritis can make individuals more susceptible to periodontal disease, necessitating proper oral care and monitoring.

Let’s focus on Signs and Symptoms of Periodontal Disease:

Recognizing early signs is crucial. Be alert for swollen, bleeding gums and persistent bad breath, as these can indicate periodontal disease.

Swollen gums that bleed easily: Red, swollen gums that bleed during gentle brushing or flossing may be indicative of gingivitis, the initial stage of periodontal disease.

Sensitive teeth: Discomfort or pain when consuming hot or cold items may signal gum recession, exposing sensitive tooth roots, often seen in advanced periodontal disease.

Bad breath: Persistent bad breath (halitosis) can be a consequence of gum disease.

Gum recession & bone loss: If your teeth appear longer or your bite changes, it may be due to gum recession and bone loss, severe indicators of advanced periodontal disease.

If you encounter any of these symptoms, seek professional dental care promptly. Early detection and treatment can halt the progression of periodontal disease and preserve your oral health. Regular dental check-ups and proper oral hygiene are vital for maintaining a healthy smile.

Diagnosis of Gum Disease:

During a routine dental exam, your dentist can diagnose gum disease by assessing plaque buildup and discussing symptoms. A periodontal probe measures pocket depths to determine the extent of bone loss. X-rays provide detailed images, helping track changes in bone structure over time. A periodontist may be consulted for further evaluation and treatment.

What steps should one take for prevention for Gum infection?

Healthy Diet:

Diet is important – sugar and starches fuel harmful oral bacteria, and lacking essential vitamins and minerals weakens your ability to fight infections. 

Routine Dental Treatment:

• Regular dental visits remove hard tartar, a key step in preventing gum disease.
• Exams are essential for early detection, often asymptomatic until advanced stages.
• Manual exams and X-rays assess gum health and bone structure.

Tobacco Use:

• Quitting tobacco is essential to prevent gum disease.
• Smoking causes tartar buildup and increases periodontal pocket risk.
• Tobacco damages oral tissues and hinders healing, raising tooth loss risk from gum disease.

What is the treatment for Periodontal Disease?

Dental Cleaning:

Early-stage periodontal disease (gingivitis) can often be reversed with regular dental cleanings and improved oral hygiene, which eliminates harmful oral bacteria. Good oral hygiene includes daily brushing (2-3 times a day), flossing, and regular dental check-ups.

Scaling and root planning:

Scaling and root planning is a deep cleaning procedure performed by dental hygienists to eliminate plaque and bacteria beneath the gums. It's recommended for mild gum disease and involves scaling off plaque and smoothing root surfaces. Typically, it requires two visits and local anaesthesia.

Pocket reduction surgery:

For moderate to advanced gum disease, pocket reduction surgery is performed to remove deep-seated plaque and tartar. This involves an incision to create a flap, cleaning and smoothing of tooth roots, and repositioning and stitching the gums. It's often combined with regenerative procedures like bone grafting or gum grafting for optimal outcomes.

LANAP (Laser-assisted new attachment procedure): Certain periodontists provide pocket reduction with LANAP, a procedure that addresses periodontitis using a handheld laser. The laser specifically targets diseased gum tissue while preserving healthy tissue. LANAP offers a less invasive option compared to traditional pocket reduction surgery, but its results may vary.

Bone grafting: A dental bone graft is a technique your periodontist might employ to replenish bone loss caused by gum disease. After eliminating the infection, they'll insert bone grafting material into the areas affected by bone erosion. This material serves as a scaffold, allowing your body to naturally regenerate bone over time.

Gum grafting: Gum graft surgery, or tissue grafting, is a recommended treatment if you've experienced gum tissue loss due to periodontal disease. It involves covering exposed tooth roots and increasing the thickness of your gum line. In this procedure, a periodontist adds tissue to the areas with gum recession. The tissue can be obtained from the roof of your mouth or sourced from a licensed bone and tissue bank.

Guided tissue regeneration (GTR): Periodontists typically utilize guided tissue regeneration (GTR) in conjunction with a bone graft. GTR is employed to repair periodontal defects, such as areas of bone breakdown, and to prevent the growth of soft tissue into these spaces. In the GTR procedure, a periodontist inserts an artificial membrane between your gums and the newly placed bone grafting material. Since soft tissue regenerates more quickly than bone, the membrane maintains the space open for new bone growth rather than allowing soft tissue to fill it.

Platelet-rich fibrin (PRF) and platelet-rich plasma (PRP): PRF and PRP are rich in growth factors that accelerate healing and tissue regeneration. A periodontist obtains them from a blood sample, separating plasma from red blood cells with a centrifuge. This therapy shortens recovery and reduces post-surgical discomfort, with the advantage of being derived from your own blood, ensuring safety.

What are the risk factors?

• Smoking or tobacco use
• Poor oral hygiene
• Diabetes
• Autoimmune diseases like lupus, scleroderma, and Crohn's disease
• Hormonal changes during puberty, pregnancy, and menopause
• Stress
• Genetics (family history of gum disease)
• Heart disease

What are the stages of periodontitis?

Periodontal disease typically progresses through four stages:

• Gingivitis: The initial stage, characterized by red, inflamed, and bleeding gums. Early intervention is crucial.
• Early Periodontitis: Receding gums, minor bone and fiber loss occur in this stage.
• Moderate Periodontitis: Further bone and fiber loss may lead to pockets forming between teeth and gums.
• Advanced Periodontitis: Severe bone and fiber loss, often resulting in tooth loss.

Prevention and home remedies for Gum Disease:

• Brush your teeth at least twice a day using a soft-bristled brush and toothpaste.
• Floss at least once a day using a length of at least 18 inches of floss.
• Incorporate an essential oil antibacterial mouthwash into your daily routine.

Periodontal disease is often painless, especially in its early stages, making it essential to recognize the warning signs for timely treatment. Untreated gum disease can impact both your oral and overall health, as the infection can spread to other mouth areas and even throughout your body, increasing the risk of various health conditions like heart disease, stroke, and diabetes.